Dr. Surah Grumet with her patient, Frances Youngquist, at the Preston Pointe Retirement Community in Morrisville, NC.CreditTravis Dove for The New York Times

Surah Grumet used to be a family doctor at a clinic in the Bronx. “It always felt like I was trying to catch up,” she said. “I was always falling behind, and it was so stressful. And it was really hard to bring up my two girls, to be there for them, and still be able to practice medicine the way that I wanted to.”

Now, she lives in a suburb of Raleigh, N.C. She still practices medicine, but has no office or clinic. Instead, she works with a Durham-based practice called Doctors Making House Calls.

Grumet puts her girls on the school bus and gets in the car just before nine. Her patients are frail elderly people with multiple chronic illnesses: memory loss, heart and blood pressure problems, arthritis that makes mobility difficult.

Grumet works full time, but on her own schedule. She can spend 15 minutes with a patient, or nearly two hours. She’s home before the school bus and completes her patient notes and paperwork while her girls do homework. She makes $70,000 more than she did when she worked in the Bronx.

Dr. Thomas Cornwell with a patient, Mary Hanrahan, at her home. “For the horribly sick, hospitals are the worst place,” he says.CreditWhitten Sabbatini for The New York Times

REMEMBER when doctors made house calls?

While only a relative handful of doctors still offer them, there is growing evidence that comprehensive home medical care could be a viable alternative to the attendant woes and soaring expenses of institutional health services, particularly for those in late retirement.

It will take some important legislative changes before focused, less intrusive care in a dignified, comfortable setting can become more widely available. The polarizing politics surrounding the Affordable Care Act makes any reform to the health care system particularly challenging. Still, given the overall popularity of Medicare — Hillary Clinton and Donald Trump both say they support it — getting a new home medical care benefit through Congress looks more promising.

At the heart of the home care renaissance is a combination of high-tech, portable medical equipment and the age-old practice of doctors coming into the home to personally examine and treat their patients.

“We can do X-rays, EKGs, medical records and other applications in the home,” said Dr. Thomas Cornwell, who has made more than 32,000 house calls in his Chicago-based practice and wants to see Medicare support more home-based medical care.

“I had a 92-year-old patient with a very high temperature,” Dr. Cornwell said, citing an example. “I brought in a portable X-ray and diagnosed pneumonia; she didn’t have to go to the hospital, and lived four more years.”

Difficulty with everyday physical functioning—the ability to perform both basic (for example, dressing, bathing, and walking) and instrumental (such as going shopping or managing one’s medications) activities of daily living—is a major cost driver that is typically overlooked and unaddressed in traditional medical care.Read More